LAS VEGAS — The US could soon have to pay more for medical care for transgender people if Congress passes a law that requires insurers to cover the care.
And a new study says the federal government should also pay for the treatment if it’s necessary.
The study from Georgetown University’s Center for American Progress shows that, if a transgender person receives gender-affirming surgery or a hormone treatment that allows them to have children, the federal Medicare program pays for the treatments, even if it costs the taxpayer money.
“That’s a major policy change, especially in the face of what we’re seeing right now in the U.S. and elsewhere,” said Lauren J. Smith, senior policy director for the Center for Transgender Equality, an advocacy group.
The Center for the Study of Health and the Economy at Georgetown estimates that a transgender woman who has gender-confirming surgery would have a lifetime cost of about $12,000, and that the cost of such care would be $18,500 in 2020.
Transgender women account for about one in 10 US adults.
The Centers for Disease Control and Prevention says nearly a third of transgender women will experience some form of gender-related health problems in their lifetime.
The study, released Friday, found that about 1.5 million transgender people would have lifetime health costs that could exceed $20 billion, including medical expenses and disability payments.
The Center’s analysis assumes that gender-transition surgery is covered under the ACA, which has been a key pillar of President Donald Trump’s efforts to undo the Obama-era gender policy changes and allow transgender people to be treated with their chosen gender at birth.
But the Centers for Medicare and Medicaid Services, the government health insurer that runs Medicare and the federal health insurance program for the poor, could face significant cost overruns if Congress adopts a similar policy.
Under the ACA’s health care reforms, the U,S.
government has a system that provides subsidies to people to buy health insurance that covers gender transition-related treatments.
Since 2016, insurers have been required to cover medically necessary treatments for gender transition and gender dysphoria, a diagnosis that includes the desire to live as the opposite sex.
A 2017 study by the National Center for Health Statistics estimated that as of July 2018, transgender people who were diagnosed with gender dysphoric disorder and sought gender-reassignment surgery accounted for 6.6 percent of all people seeking gender-change surgeries, or about 9.3 million people.
As of April 2018, the Centers For Medicare and Medicare-Part D covered gender-identifying surgeries in about half of all private plans.
The other half covered the procedures for the most common reason, such as a gender dysphorical disorder.
Some critics have argued that gender reassignment surgeries are a cosmetic surgery and are not medically necessary, and the Center’s findings could force the insurers to change their policies.
“It’s an important step forward in our fight against discrimination and inequality,” said Katherine Husted, executive director of the Transgender Law Center, an anti-discrimination organization.
“But we must also recognize that the federal and state governments have an obligation to pay for all medically necessary gender-treatment.
That’s a key part of ensuring access to care for all Americans, including transgender people.”
The Center is an independent research and policy organization that focuses on health care policy and health care access.
Its analysis was funded by the Health Care and Education Foundation and the National Gay and Lesbian Task Force.